Think doctors know about nutrition? Think again

Because we all know that nutrition affects health, most people naturally assume that it is something doctors must undergo extensive training in.

The reality?

Although it varies depending on where they studied, any aspiring doctor in the UK or US who wishes to progress their nutritional know-how beyond that of the average high school biology student must get that education somewhere other than medical school.

For example, an article published in the April 2006 edition of the American Journal of Clinical Nutrition reveals exactly how many hours of nutrition education US doctors receive during their four years in medical school.

In 2004, the authors surveyed all 126 US medical schools on this topic and 106 of them (84%) responded, making it the most comprehensive survey of its kind.

The findings? In 17 of the medical schools, students were getting less than 10 hours of nutrition education during their entire four years and in over half of the schools, they were receiving no more than 20 hours.

This despite the fact that a landmark 1985 report by the National Academy of Sciences recommended a minimum of 25 hours of nutrition education for medical students.

The 2004 survey revealed that only 40 of the schools were meeting this (paltry and itself woefully inadequate) minimum.

The researchers reported that the average medical student received “23.9 contact hours of nutrition instruction during medical school” concluding: “The amount of nutrition education in medical schools remains inadequate” and that, “practicing physicians continually rate their nutrition knowledge and skills as inadequate”.

This is a problem of enormous magnitude. Quoting from the article text again, “Patients routinely seek physicians’ guidance about diet, and the relation of nutrition to the prevention and treatment of disease is well known.”

Compounding the issue, many practising physicians completed their token nutrition training years or even decades ago and have not revisited the topic since then.

As author John McDougall, M.D. pointed out recently, “A doctor and his secretary know the same about nutrition unless she happens to be on a diet – and then she knows more.”

McDougall is among the minority of medical doctors who have engaged in additional study to become highly educated in nutrition, and he has saved thousands of lives by sharing what he knows with his patients.

He made the above statement while testifying before the California State Senate in late April in favour of a bill he has authored (SB 380), which would require all doctors in California to include a course in nutrition as part of their continuing medical education.

Specifically, doctors would learn about the relationship between diet and common illnesses, so that they can guide their patients in diet changes which address the causes of their conditions (rather than continuing to rely on drugs, surgery and other interventions that merely attack the symptoms).

The California Medical Association strongly opposed the bill, but a modified version of it was passed on May 2.

There is still the question of who will provide the education and just how far it will go towards telling doctors what they really need to know about nutrition. There is also the fact that this is just one state in one country.

Nonetheless, this is groundbreaking and a huge step in the right direction.

From Dr McDougall’s testimony before the Senate Committee:

“The majority of diseases in this country are diet-related and that goes without any question. Two-thirds of people are overweight. They predict that 30% of people will have type-2 diabetes soon. Heart disease is a $100 billion a year business just for the surgeries. Without question these are dietary diseases yet physicians who have been trained for 7+ years know virtually nothing about human nutrition. And not only is this a travesty for the patients. It’s insulting to the doctor not to be able to deliver this powerful tool for their patients, to teach them about dietary diseases. Based on the scientific literature, if you correct what’s making people sick, they get well.

“As doctors we’re missing a real opportunity. As far as business and the government is concerned, we’re talking about 16% of the Gross National Product of this country is due to disease. Three-quarters of that is due to chronic disease and I’m here to tell you, based on my experience of more than 40 years, that most of that disease is due to the rich Western diet that we eat and doctors know virtually nothing about it. This should have been fixed 40 years ago when I was a medical student, and it should have been fixed 2 years ago when my son graduated medical school. And it’s not going to be fixed unless someone does something about it, and that is to mandate basic education on human nutrition.”